Individual
MRS. DANIELLE ELIZABETH BRUNELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MPT, LATC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
15205
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7875155
—
MA
01
—
CAQH
10742810
MA
Enumeration date
12/03/2007
Last updated
09/28/2011
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